NPIMap

Organization Active NPI

New Mercy Behavioral Health LLC

  • Clinical Social Worker
  • Jackson, MS
National Provider Identifier
1114480753
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
NEW MERCY BEHAVIORAL HEALTH LLC
Practice address
135 Bounds St
Jackson, MS 39206-4121
Phone
(601) 808-1820
NPI assigned
Apr 10, 2019
Last updated
May 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lynette Clark
Title
Credentialing Manager
Phone
(770) 339-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

135 Bounds St
Jackson, MS 39206-4121

Mailing address

PO Box 1491
Augusta, GA 30903-1491
Phone (601) 808-1820

Other practice location 1

207 Hudson Trce
Augusta, GA 30907-2010
Phone (601) 808-1820

National Provider Directory

National Provider Directory

Locations

135 Bounds St
Jackson, MS 39206
Phone (601) 382-4523

135 Bounds St
Ste 107
Jackson, MS 39206
Phone (601) 808-1820

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1114480753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1491",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031491",
            "telephone_number": "601-808-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 BOUNDS ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392064121",
            "telephone_number": "601-808-1820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Hudson Trce",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309072010",
            "country_code": "US",
            "telephone_number": "601-808-1820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW MERCY BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "770-339-7667"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.